Depression and anxiety predicted more daily pain and poorer physical and mental quality-of-life in adults with SCD, and accounted for more of the variance in all domains of quality-of-life than hemoglobin type.

Palavras-chavesSatisfação profissional, impacto do trabalho, qualidade de vida, saúde ocupacional. resumo objetivo: Avaliar o impacto da carga de trabalho sobre a satisfação profissional, a qualidade de vida e a prevalência de transtornos psiquiátricos menores em profissionais de saúde mental. mé-todo: Estudo transversal com amostra de 203 profissionais de saúde mental. Foram aplicados os instrumentos: IMPACTO-BR, SATIS-BR, SRQ-20 e um questionário sociodemográfico ocupacional. resultados: 75,4% dos participantes eram do sexo feminino, com idade média de 33,7 anos (DP = 9); 15,8% dos participantes apresentaram transtornos psiquiátricos menores. Em relação ao trabalho, obteve-se nível de satisfação global mediano (escore 3,59; DP = 0,485). O impacto global foi avaliado como pequeno (escore 1,85; DP = 0,536). Sobre a qualidade de vida, houve prejuízo nos subitens dor, estado geral de saúde e vitalidade. conclusão: Os dados obtidos com esta pesquisa demonstram que os profissionais que atuam na área da saúde mental sentem-se mais satisfeitos em relação à qualidade dos serviços oferecidos e ao trabalho realizado em equipe. O fator que gerou menor satisfação está relacionado às condições de trabalho oferecidas. Foram observados escores mais elevados na subescala referente ao impacto emocional, assim como maior presença de transtornos psiquiátricos menores nos profissionais de terapia ocupacional e serviço social. Profissionais que trabalham mais de 20 horas semanais apresentam prejuízos na qualidade de vida.. ABstrAct

In several types of chronic pain, catastrophizing has been related to higher pain intensity, and health care utilization but it has not been explored extensively in sickle cell disease (SCD). The objective of the study was to identify the role of catastrophizing in SCD, specifically in relation to painful crises, non-crisis pain, and responses to pain. Two hundred and twenty SCD adults were enrolled in a prospective cohort study of pain and completed between 30 and 188 daily diaries in 6 months. The Catastrophizing subscale (CAT) of the Coping Strategy Questionnaire (CSQ) was administered at baseline and at study exit. Depression and quality of life were measured by the Patient Health Questionnaire and SF-36, respectively, at baseline. The CAT mean was 13.6 (SD=8.4) and higher CAT was correlated with greater depression severity (r=0.48; p<0.001) and poorer quality of life in all domains (r=-0.24 to -0.47; p<0.001). There was no significance difference between CAT mean baseline and exit scores, and the measures were strongly correlated within patients (r=0.69; p<0.001). No difference was found between higher and lower catastrophizers in intensity of pain, distress, interference, and health service utilization, both on crisis or non-crisis SCD-related pain days, after controlling for depression. Adults with SCD had a higher mean catastrophizing score than found in studies of other chronic pain conditions that are not lifelong and life-threatening. CAT scores were not correlated with pain parameters or utilization. The role of catastrophizing in other conditions cannot be generalized to SCD.

Objectives: Bibliographic review on occupational stress and burnout presence in physicians and nurses that work in pediatric and neonatal intensive care units. Methods: The articles were selected from the MedLine, LILACS and Sci-Elo data base using the key words: stress, burnout, physicians, nursing, intensive care unit, pediatric intensive care unit and neonatal intensive care unit. The studied period was from 1990 to 2007. Results: Health professionals who work in pediatric and neonatal intensive care units are strong candidates for developing stress, psychological alterations and burnout syndrome. Researches on this subject identified important alterations suffered by these physicians and nurses, such as: work overload, burnout, desires of giving up their jobs, high levels of cortisol, among other alterations. Conclusions: Professionals, who work in pediatric and neonatal intensive care units, due to the specificity of their job, are liable of developing occupational stress, and consequently burnout. These results suggest the need to research the matter further, with the objective of developing preventive measures and intervention models.

A review on adherence to highly active antiretroviral therapy and the quality of life of patients living with HIV in the scientifi c literature, indexed in MEDLINE between 1998 and 2008, was performed. Studies published in Portuguese, Spanish or English with patients over 18 years of age were included. Reviews, case reports and letters were excluded. Of the 21 studies found, 12 were included (three clinical trials, three prospective cohorts and six cross-sectional studies). The relationship between quality of life and treatment adherence remains controversial, despite descriptive studies indicating the possibility of a positive association. The results may have been infl uenced by the specifi c characteristics of the described clinical trials and do not show a consensus regarding the impact of treatment adherence on patients' quality of life.

Health-related quality of life predictors during medical residency in a random, stratified sample of residents Preditores de qualidade de vida relacionada à saúde durante a residência médica em uma amostra randomizada e estratificada de médicos residentes

We present data regarding the care provided to graduate level health professionals at the mental health center of the Federal University of São Paulo. From September 1996 to September 2003, 146 graduate students (99 in the Master's degree program and 47 in the Doctoral program) were attended. This population was predominantly female (68.5%), with a mean (± SD) age of 28.6 ± 4.42 years, not married (71.9%). Most of the subjects were professionals who had not graduated from the Federal University (78.1%). The students who sought help for psychological and/or psychiatric problems were classified into two categories: situational-adaptive crises and psychopathological crises. The main diagnoses were depression and anxiety disorders (44%) causing 4.5% of the subjects to be temporarily suspended from their graduate studies; 19.2% reported that they had used psychotropic drugs within the previous month, and 47.9% referred to sleep disturbances. Suicidal tendencies were mentioned by 18% of those interviewed. Students with emotional disturbances and academic dysfunctions should be recognized at an early stage, and it is fundamental for them to have access to mental health programs that provide formal, structured and confidential care. Thus, it is important that professors and advisors in graduate programs build a warm and affective learning environment. If we consider the expressive growth in Brazilian scientific production resulting from the implementation of an extensive national system of graduate education, it is important to focus efforts on enhancing and upgrading the mental health care system.

No abstract